If you work for an organization that contracts with the federal government, you may have observed questionable or even fraudulent activity. Did you know you could earn a substantial reward by blowing the whistle on fraud, waste or abuse of a federal contract or program? The reward could be between 15 and 30 percent of any money recovered on behalf of the government.
"By bringing allegations of fraud to light, whistleblowers play an important role in protecting the integrity of our healthcare system," says the U.S. Attorney for the Western District of Pennsylvania.
The False Claims Act invites private-citizen whistleblowers to file lawsuits against companies that they believe are engaging in fraud, waste or abuse in government contracting. When these lawsuits are successful, the whistleblower can receive a substantial portion of the money recovered as a reward for their service. Sometimes, the federal government intervenes in these lawsuits, which does not affect the whistleblower's rights but sometimes improves the lawsuit's chances for success.
Vascular Access Centers L.P., along with 23 subsidiaries and related corporations, has been accused of Medicare fraud, violating the False Claims Act, and violating the Anti-Kickback Statute and have agreed to pay at least $3,825 million to resolve the allegations. If certain contingencies arise, additional payments up to $18,360,794 could be triggered.
The Hunters Point Naval Shipyard in San Francisco is being redeveloped into housing and commercial space. Between 1946 and 1969, however, the former Navy shipyard was involved in activities that created significant amounts of radioactive waste. First, the facility was the location of top-secret nuclear tests. Second, it was where ships were decontaminated after returning from hydrogen bomb tests. Cleaning up the radioactive waste is expected to cost at least $1 billion.
Between Jan. 1, 2006 and Dec. 31, 2011, the Justice Department says, a Miami-based mortgage originator called the Universal American Mortgage Company LLC (UAMC) knowingly originated mortgages under the Federal Housing Administration mortgage insurance program that did not qualify with that program's lending requirements. These defective loans violated the False Claims Act because the FHA mortgage insurance program is left on the hook when its insured mortgages go into foreclosure.
When someone blows the whistle on fraud, waste or abuse in federal programs, they can often receive as a reward a substantial portion of any money recovered on behalf of the government. This is called the qui tam provision of the federal False Claims Act. In a recent pair of consolidated False Claims Act cases, the whistleblower will receive a reward of $5,411,521.
Medicare Advantage plans are owned and operated by private organizations called Medicare Advantage Organizations (MAOs). Medicare beneficiaries can enroll in and obtain healthcare through these plans. Unlike in traditional Medicare, MAOs are not paid based on services rendered but instead receive a fixed monthly amount for each beneficiary's care. Since some patients require more care than average, payments from Medicare to MAOs are "risk adjusted" to reflect the beneficiary's health status. In other words, MAOs receive higher payments for patients whose conditions require more care.
The federal government intervened in eight False Claims Act lawsuits and brought criminal charges against Health Management Associates, LLC (HMA), a hospital chain that has since been sold. According to the Justice Department, HMA engaged in a scheme to defraud the U.S. The allegations include:
It was an interesting scheme. According to allegations by the Department of Justice, Reliant Rehabilitation Holdings, Inc., wanted to induce or reward its client nursing homes for referring patients to Reliant for rehabilitation therapy. So, it sent over nurse practitioners employed by Reliant to work for those nursing homes for free or below market value.